China Perspectives 2009/1 | 2009 Chinese Society Confronted with AIDS The Transnational Origin of a Local Response to HIV/AIDS in Henan Province Vincent Rollet Electronic version URL: http://journals.openedition.org/chinaperspectives/4769 DOI: 10.4000/chinaperspectives.4769 ISSN: 1996-4617 Publisher Centre d'étude français sur la Chine contemporaine Printed version Date of publication: 1 April 2009 Number of pages: 17-28 ISSN: 2070-3449 Electronic reference Vincent Rollet, « The Transnational Origin of a Local Response to HIV/AIDS in Henan Province », China Perspectives [Online], 2009/1 | 2009, Online since 01 April 2011, connection on 28 October 2019. URL : http://journals.openedition.org/chinaperspectives/4769 ; DOI : 10.4000/chinaperspectives.4769 © All rights reserved Special feature s e The Transnational Origin of v i a t c n i a Local Response to e h p s c HIV/AIDS in Henan r e Province p VINCENT ROLLET For several years now, at a time when Henan remains one of the areas of China most heavily affected by the HIV/AIDS virus, peasants in several of the worst affected villages have supplemented the official policies and strategic approaches to deal with its spread by progressively mobilising and organising their own local measures to deal with the social challenges that AIDS imposes on rural communities. This article is particularly concerned with the transnational origin behind this local mobilisation. The social, political, and ics, or even beyond, without any testing for the presence of epidemiological context of the HIV. mobilisation Despite the fact that the presence of HIV in the blood col - lected in this way was discovered by the Henan authorities The commercial blood collections at the in 1995, and the villagers themselves were astonished at the source of the epidemic increasing number of deaths and illnesses around them (some even questioning local officials about the prevalence In the 1980s and 1990s, many villagers in Henan Province of this “unknown” disease (3) ), the provincial and local au - as well as other provinces (Anhui, Hubei, Hebei et al. ), thorities decided to conceal the truth, and knowingly contin - under the twin pressures of poverty and official exhortation, ued with the profitable trade in blood at the expense of the sold their blood at collection points organised by the local health of millions of Chinese. authorities. (1) These authorities, who paid them 50 yuan for In 1996, Gao Yaojie, a gynaecologist working in a hospital each donation, viewed such measures as a way of enriching in Zhenzhou, the provincial capital of Henan, discovered the peasants while also meeting the need for blood, the im - HIV in a peasant woman who had given blood several years portation of which had been forbidden since 1985, largely earlier at a rural collection point. Aware that this case repre - out of fear of HIV. (2) Massive numbers of poor villagers sented the tip of an iceberg, Dr. Gao decided to launch a turned out to give their blood several times a week in ex - preventive campaign at her own expense, using explanatory change for a pittance that enabled them to feed their fami - lies, pay their taxes, or provide for their children’s education. * The author thanks the members of the Taiwanese NGO Harmony Home as well as However, these blood collections were carried out under the peasants of the various villages in Henan Province where the field survey was carried out. He also extends his thanks to Evelyne Micollier, who invited him to join minimal sanitary conditions. The syringes were reused, there the IRD-PUMC/CAMS project. was no system for tracing the blood bags, and when all the 1. See in particular Pierre Haski, Le sang de la Chine, Quand le silence tue , Grasset blood had been mixed together and put through a centrifuge & Fasquelle, Paris, 2005, 228 pp. to extract the plasma, it was re-injected into the donors. This 2. “China Bans Import of Blood Products,” Xinhua , 3 September 1985. 3. Based on an interview with Mr. Lin, a villager from Shenqiu County, Henan blood was then sold on to the provincial hospitals and clin - Province, 20 June 2007. 17 N o 2009/1 Special feature s e v i a t leaflets and a book that she compiled, in order to inform as 1995, there had been 6,524 officially registered cases of c n i e many Henan residents as possible of the risks they were run - HIV, out of which 1,940 had developed into AIDS. Yet h p ning through their paid blood donations. At the same time, in 2003, when it was clear that the whole of China had s c r she also gave financial support to several villagers and or - been affected by the trade in blood, (10) some experts in e (4) p phans affected by the disease. Yet the Henan authorities epidemiology estimated that there were actually 35,000 maintained their silence, denying the presence of AIDS in people in Henan who had tested positive. (11) In 2004, the their province, and trying by all possible means to prevent central health authorities declared that they had diag - Dr. Gao and her team of helpers from continuing with their nosed 16,000 HIV cases in Henan, but they also ac - preventive work in Henan, and specially from mentioning knowledged that this represented a minimum number, the situation in public. (5) since many blood donors had not been traced. (12) In the It was particularly after the year 2000 that a certain amount same year the reality of this situation was confirmed by a of information about the HIV/AIDS situation in Henan study concluding that 25,036 people in Henan had con - Province came to light. In October of that year, Dr. Gui tracted HIV, and that 11,815 of them had gone on to de - Xian revealed that out of the 155 blood samples he had se - velop AIDS. It also established that, depending on the cretly collected in Shangcai County, where the sale of blood county concerned, between 8 percent and 20 percent of had become commonplace, 65 percent had tested positive those who had sold their blood had been infected. (13) In for HIV. Also, China News Weekly revealed that in several 2005, following a huge official tracing exercise among villages in that county there were families who had lost mem - Henan’s 100 million inhabitants, the Chinese Ministry of bers to AIDS. For its part, the international press revealed Health registered 29,337 cases of HIV, which included that a doctor from Beijing, who had inspected a number of 16,456 cases of AIDS. Out of those who tested positive, rural hospitals in Henan without permission, had discovered 90 percent were former blood donors and 98 percent were an abnormally high number of HIV infections, (6) and that peasants. (14) By the end of 2006, according to the Chinese the village of Wenlou in Shangcai County had experienced government, the number of HIV cases in Henan stood at 800 deaths from AIDS in two years. (7) 35,232, out of whom 21,828 had AIDS and 75 percent International governmental organisations and NGOs, as well had given blood at least once. (15) as some prominent figures in Chinese medical circles and Yet these figures are in reality vast under-estimates, largely other concerned groups, paid close attention and alerted the because of the extreme difficulty in carrying out tracing central and provincial authorities to the urgent need to re - procedures among the peasants in Henan. Given the wide spond to the situation in Henan if they did not wish to face an HIV/AIDS epidemic spreading throughout the whole of 4. Gao Yaojie, “My AIDS journey,” available at http://www.org/Chindoc/gao_jrny.htm. (con - China. At the beginning of August 2001, in order to clarify sulted on 4 January 2009). Gao Yaojie gave out 300,000 copies of her book, The pre - vention and treatment of AIDS and venereal diseases , and 610,000 copies of her leaflet the situation in Henan, the central government sent in a “How to protect against AIDS.” She was awarded the Jonathan Mann prize for Global team from its working group on the prevention and treatment Health and Human Rights in 2001. of HIV/AIDS. They concluded that “illegal” blood collec - 5. According to an interview with Dr. Gao in Zhengzhou, Henan, May 2006. 6. Elizabeth Rosenthal, “In Rural China, a Steep Price of Poverty: Dying of AIDS,” The New tion centres were the main source of the widespread propa - York Times , 28 October 2000, p. A1. (8) gation of HIV among paid blood donors. A few weeks 7. “Chinese Villages ‘Devoured’ by AIDS: Locals Ordered to Keep Silent,” Agence France later the Ministry of Health officially acknowledged, for the Presse, 30 November 2000. first time, that villagers from some provinces in central China 8. “Illegal Blood Trade Contributed to Rural HIV Epidemic,” Renmin Ribao , 9 August 2001, p. 6. had been infected by HIV after selling their blood in the col - 9. “PRC Health Ministry Official: China to Act Sternly against Illegal Blood Deals,” Xinhua , lection centres, and that drastic measures needed to be taken 23 August 2001. against the trade. (9) 10. State Council HIV/AIDS Working Committee Office and UN Theme Group on HIV/AIDS in China (2004), A Joint Assessment of HIV/AIDS Prevention, Treatment and Care in China , 1 December 2004. The extent of HIV infection in Henan and 11. “HIV carriers in Henan estimated at 35,000,” China Daily , 17 November 2003. its social consequences 12. “More HIV cases expected in Henan,” China Daily , 29 June 2004.